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sleep stroke

David Stevens, Rodrigo Tomazini Martins, Sutapa Mukherjee, Andrew Vakulin
Sleep-disordered breathing (SDB), encompassing both obstructive and central sleep apnea, is prevalent in at least 50% of stroke patients. Small studies have shown vast improvements in post-stroke functional recovery outcomes after the treatment of SDB by continuous positive airway pressure. However, compliance to this therapy is very poor in this complex patient group. There are alternative therapy options for SDB that may be more amenable for use in at least some post-stroke patients, including mandibular advancement, supine avoidance, and oxygen therapy...
2018: Frontiers in Surgery
Rachel P Ogilvie, Kamakshi Lakshminarayan, Conrad Iber, Sanjay R Patel, Pamela L Lutsey
BACKGROUND: Although excessive daytime sleepiness (EDS) is a common symptom of obstructive sleep apnea (OSA), and both EDS and OSA have separately been associated with increased risk of cardiovascular disease (CVD), their joint association with CVD risk is unknown. METHODS: Among 3874 Sleep Heart Health Study (SHHS) participants without prevalent CVD, moderate to severe OSA was defined by an apnea hypopnea index (AHI) ≥ 15 on an in-home polysomnography. EDS was defined as an Epworth Sleepiness Scale score ≥11...
April 2018: Sleep Medicine
Anne-Kathrin Brill, Thomas Horvath, Andrea Seiler, Millene Camilo, Alan G Haynes, Sebastian R Ott, Matthias Egger, Claudio L Bassetti
OBJECTIVE: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effectiveness of continuous positive airway pressure (CPAP) in stroke patients with sleep disordered breathing (SDB). METHODS: In a systematic literature search of electronic databases (MEDLINE, Embase, and the Cochrane Library) from 1980 to November 2016, we identified RCTs that assessed CPAP compared to standard care or sham CPAP in adult patients with stroke or TIA with SDB...
March 9, 2018: Neurology
Devin L Brown, Chengwei Li, Ronald D Chervin, Erin Case, Nelda M Garcia, Susan D Tower, Lynda D Lisabeth
Background: We sought to investigate the frequency of wake-up stroke (WUS) and its association with sleep-disordered breathing (SDB) in women. Methods: Within a population-based study, women with acute ischemic stroke were asked about their stroke symptom onset time. SDB screening was performed with the well-validated ApneaLink Plus device; SDB was defined by a respiratory event index ≥10. Logistic regression was used to test the association between SDB presence and severity and WUS unadjusted and adjusted for potential confounders including prestroke depression and sleep duration...
February 2018: Neurology. Clinical Practice
Man Amanat, Mona Salehi, Nima Rezaei
Psoriasis used to be known as a skin disorder; however, it can now be considered as a systemic disease with the involvement of multiple organs. Neurological and psychiatric disorders are some of the associated problems that can be observed in patients with psoriasis. Stroke, multiple sclerosis, seizure, migraine, restless leg syndrome, Parkinson's disease, Guillain-Barré syndrome, and myasthenia gravis are the reported neurological diseases, while depression, bipolar mood disorder, anxiety, psychosis, cognitive impairment, personality disorders, sexual disorders, sleep disturbance, and eating disorders are the recognized psychiatric presentations in patients with psoriasis...
March 6, 2018: Reviews in the Neurosciences
Bernhard Meier
A patent foramen ovale (PFO) is not to be considered a disease as it is present in about 25 % of people. Yet, it is the prime reason for paradoxical embolism that can cause serious problems, such as death, stroke, myocardial infarction, and peripheral ischemia. The frequency of such events is probably underestimated as other causes tend to be blamed for them. Device PFO closure can be easily accomplished as outpatient procedure with minimal discomfort and risk and it has been referred to as mechanical vaccination...
March 2018: Deutsche Medizinische Wochenschrift
Jin Soo Kim, Seongheon Kim, Seung Hwan Lee, Hee Young Lee, Seo Young Lee, Kyoung Bin Im
BACKGROUND AND PURPOSE: The literature indicates that obstructive sleep apnea (OSA) increases the risk of ischemic stroke. However, the causal relationship between OSA and ischemic stroke is not well established. This study examined whether preexisting OSA symptoms affect the onset of acute ischemic stroke. METHODS: We investigated consecutive patients who were admitted with acute ischemic stroke, using a standardized protocol including the Berlin Questionnaire on symptoms of OSA prior to stroke...
February 28, 2018: Journal of Clinical Neurology
Woo Hyun Lee, Jeong-Whun Kim, Jae-Sung Lim, Il Gyu Kong, Hyo Geun Choi
BACKGROUND: Several studies have reported that chronic rhinosinusitis (CRS) increases the risk of stroke. The aim of this study is to elucidate the putative association between CRS and stroke (ischemic or hemorrhagic) using large population-based national health insurance data. METHODS: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, CRS patients (n = 22,959) and control participants (n = 91,836) were selected and matched at a rate of 1:4 (age, sex, income, region, hypertension, diabetes, and dyslipidemia)...
2018: PloS One
Gaurav Gadodia, Srikant Rangaraju, Syed A Raza, Ammar Razzak, Labib Marmarchi, Brittaine Davis, Laura Henriquez, Lynn M Trotti, David Rye, Fadi Nahab
INTRODUCTION: Obstructive sleep apnea (OSA) and periodic limb movements (PLMs) have been associated with an increased risk of cardiovascular disease. There is limited data on the relationship between OSA and PLMs with atrial fibrillation and resistant hypertension in stroke and transient ischemic attack (TIA) patients. METHODS: Consecutive stroke and TIA patients referred by a vascular neurologist for diagnostic polysomnography (PSG) from September 1, 2012 to August 31, 2015 were included in a retrospective analysis...
March 2018: Neurologist
Lin-Hui Wang, Zi-Lan Wang, Wen-Yue Chen, Ming-Jia Chen, Guang-Yin Xu
The glymphatic system is a cerebrospinal fluid-interstitial fluid exchange system dependent on the water channel aquaporin-4 polarized on astrocyte endfeet, which is proposed to account for the clearance of abnormal proteins (e.g. β-amyloid) and metabolites (e.g. lactate) from the brain. Accumulating studies have revealed that glymphatic activity during sleep and general anesthesia is dramatically enhanced, while its function is significantly damaged during aging, traumatic brain injury, Alzheimer's disease, stroke, and diabetes...
February 25, 2018: Sheng Li Xue Bao: [Acta Physiologica Sinica]
Laura B Ponsaing, Ulrich Lindberg, Egill Rostrup, Helle K Iversen, Henrik B W Larsson, Poul Jennum
OBJECTIVE: Obstructive sleep apnea (OSA) is an independent risk factor for stroke. Little is known about the cerebrovascular hemodynamic changes during apnea. Hypercapnia occurs in apneas and hypopneas, and a reduced cerebral vasodilatory response to CO2 could compromise the cerebral blood flow (CBF). Therefore, we aimed to evaluate whether the apnea-hypopnea index (AHI) affected the cerebrovascular response to CO2 . METHODS: A total of 11 patients with OSA were compared to 16 controls...
March 2018: Sleep Medicine
Mollie McDermott, Devin L Brown, Chengwei Li, Nelda M Garcia, Erin Case, Ronald D Chervin, Lewis B Morgenstern, Lynda D Lisabeth
OBJECTIVE/BACKGROUND: Sleep-disordered breathing (SDB), an independent risk factor for stroke, is associated with worse post-stroke outcomes. Differences in the relationship between SDB and stroke may exist for women versus men. In this population-based study, we compared the prevalence of both pre- and post-stroke SDB by sex. We also explored whether menopausal status is related to post-stroke SDB. PATIENTS/METHODS: We performed a cross-sectional study of subjects enrolled in the Brain Attack Surveillance in Corpus Christi (BASIC) project...
March 2018: Sleep Medicine
Katie Herron, Lorna Farquharson, Abigail Wroe, Annette Sterr
BACKGROUND: Cognitive behavioural therapy for insomnia (CBTI) has been successfully applied to those with chronic illness. However, despite the high prevalence of post-stroke insomnia, the applicability of CBTI for this population has not been substantially researched or routinely used in clinical practice. AIMS: The present study developed a 'CBTI+' protocol for those with post-stroke insomnia and tested its efficacy. The protocol also incorporated additional management strategies that considered the consequences of stroke...
February 26, 2018: Behavioural and Cognitive Psychotherapy
Ragnhild L Tveit, Sverre Lehmann, Bjørn Bjorvatn
STUDY OBJECTIVES: The objective was to investigate the prevalence of heart attack, angina pectoris, stroke, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, asthma and obesity in relation to the presence and severity of obstructive sleep apnea. METHODS: The sample consisted of 1887 patients, with mean age of 48.6 years (range 16-83 years), referred to a university hospital on suspicion of obstructive sleep apnea. The patients filled out a questionnaire asking whether they were previously diagnosed with the comorbidities in interest...
2018: PloS One
Juzhong Ke, Xianfeng Zhou, Hua Qiu, Siyu Yu, Kang Wu, Xinyi Rui, Xiaonan Wang, Xiaolin Liu, Tao Lin, Xiaonan Ruan
BACKGROUND: Most previous studies on sleep duration and cardio-cerebral vascular disease (CCVD) association have not adequately controlled for many confounders. The current study prospectively examined the association of sleep duration with CCVD prevalence in a Chinese community population; cardiovascular risk factors, chronic diseases, and sleep quality were taken into consideration. METHODS: A cross-sectional study conducted in Pudong New Area of Shanghai, China...
February 2018: Sleep Medicine
Kevin M Kelly, Peter I Jukkola, Guo Yin, Eric R Miller, Elena A Kharlamov, Deng-Shan Shiau, Roger Strong, Jaroslaw Aronowski
The mechanisms of injured brain that establish poststroke seizures and epilepsy are not well understood, largely because animal modeling has had limited development. The main objective of this study was to determine whether an arterial occlusion model of cortical stroke in young adult and aged rats was capable of generating either focal or generalized epileptic seizures within 2 months of lesioning. Four- and 20-month-old male Fischer 344 (F344) sham-operated controls and those lesioned by transient (3 h) unilateral middle cerebral artery (MCA) and common carotid artery (CCA) occlusion (MCA/CCAo) were studied by video-EEG recordings up to 2 months post-procedure...
February 10, 2018: Epilepsy Research
Praew Kotruchin, Satoshi Hoshide, Kazuomi Kario
The impact of a nondipping blood pressure (BP) pattern, defined as (awake systolic BP - sleep systolic BP)/awake systolic BP < 0.1, on cardiovascular events in populations with different degrees of carotid atherosclerosis is uncertain. The authors hypothesized that a nondipping BP pattern would show differential predictive power for cardiovascular events, including total cardiovascular death, sudden death, nonfatal cardiovascular events, and nonfatal stroke, between populations with and without carotid atherosclerosis...
February 16, 2018: Journal of Clinical Hypertension
Navneet K Singh, Alexander J Sweidan, Sarah Strube, Ignacio Carrillo-Nunez
Neuromyelitis optica spectrum disorders (NMOSDs) are a set of demyelinating disorders that primarily target the optic nerves and the spinal cord. Previously thought to be a subset of multiple sclerosis (MS), now is recognized as a distinct entity. We present a 59-year-old female patient who was admitted for acute upper and lower extremity weakness. The patient had woken up from sleep with sudden onset of weakness. Patient was initially diagnosed with a right hemispheric stroke; however, magnetic resonance imaging of the cervical spine later performed showed abnormal enhancement from C2-C4, representing transverse myelitis...
2018: Clinical Medicine Insights. Case Reports
Namita Patel, Afsaneh Raissi, Sara Elias, Maneesha Kamra, Tetyana Kendzerska, Brian J Murray, Mark I Boulos
BACKGROUND: Home sleep apnea testing (HSAT) underestimates obstructive sleep apnea (OSA) severity. Overnight oxygen desaturation has been shown to be a strong predictor of incident stroke, and may be helpful in determining which patients with lower apnea-hypopnea indices (AHIs) should be offered treatment. OBJECTIVES: To examine whether a modified definition for OSA that uses oxygen desaturation (i.e., AHI 5-14.9 per hour and lowest O2 desaturation ≤88%), as compared to an AHI ≥ 15 per hour, would impact: (1) changes in Epworth Sleepiness Scale scores post-continuous positive airway pressure (CPAP) initiation; (2) CPAP compliance rates; and (3) the accuracy of automated versus manual scoring of HSAT...
February 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Ahmed Dalmar, Maharaj Singh, Bennet Pandey, Christopher Stoming, Zoe Heis, Khawaja Afzal Ammar, M Fuad Jan, Indrajit Choudhuri, Thomas Y Chua, Jasbir Sra, A Jamil Tajik, Arshad Jahangir
Weight loss after bariatric surgery is associated with reduction in adverse cardiovascular outcomes; however, the impact of obstructive sleep apnea (OSA) on reduction of cardiovascular outcomes after bariatric surgery in morbidly obese patients is not known. We retrospectively assessed differences in cardiovascular events after laparoscopic adjustable gastric banding (LAGB)-induced weight loss in patients with and without OSA before and after propensity score matching for age, sex, body mass index (BMI), and major comorbidities between the two groups and determined predictors of poor outcomes...
February 7, 2018: Sleep
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